Welcome to MSF Field Research

 

MSF is known for its humanitarian medical work, but it has also produced important research based on its field experience. It has published articles in over 100 peer-reviewed journals and they have often changed clinical practice and been used for humanitarian advocacy. These articles are available for free, in full text - no login required. We sincerely thank the publishers for their permission to archive on this site.

 

Published Research and Commentary
Conference Abstracts
Programme Descriptions
Research Resources

 

  • 'SILVAMP TB LAM' rapid urine tuberculosis test predicts mortality in hospitalized HIV patients in South Africa.

    Sossen, B; Broger, T; Kerkhoff, AD; Schutz, C; Trollip, A; Moreau, E; Schumacher, SG; Burton, R; Ward, A; Wilkinson, RJ; et al. (Oxford University Press, 2020-01-09)
    Reducing diagnostic delay is key towards decreasing tuberculosis-associated deaths in people living with HIV. In tuberculosis patients with retrospective urine testing, the point-of-care Fujifilm SILVAMP TB LAM (FujiLAM) could have rapidly diagnosed tuberculosis in up to 89% who died. In FujiLAM negative patients, the probability of 12-week survival was 86-97%.
  • Prevention and control of cholera with household and community water, sanitation and hygiene (WASH) interventions: A scoping review of current international guidelines.

    D'Mello-Guyett, L; Gallandat, K; Van den Bergh, R; Taylor, D; Bulit, G; Legros, D; Maes, P; Checchi, F; Cumming, O (Public Library of Science, 2020-01-08)
    INTRODUCTION: Cholera remains a frequent cause of outbreaks globally, particularly in areas with inadequate water, sanitation and hygiene (WASH) services. Cholera is spread through faecal-oral routes, and studies demonstrate that ingestion of Vibrio cholerae occurs from consuming contaminated food and water, contact with cholera cases and transmission from contaminated environmental point sources. WASH guidelines recommending interventions for the prevention and control of cholera are numerous and vary considerably in their recommendations. To date, there has been no review of practice guidelines used in cholera prevention and control programmes. METHODS: We systematically searched international agency websites to identify WASH intervention guidelines used in cholera programmes in endemic and epidemic settings. Recommendations listed in the guidelines were extracted, categorised and analysed. Analysis was based on consistency, concordance and recommendations were classified on the basis of whether the interventions targeted within-household or community-level transmission. RESULTS: Eight international guidelines were included in this review: three by non-governmental organisations (NGOs), one from a non-profit organisation (NPO), three from multilateral organisations and one from a research institution. There were 95 distinct recommendations identified, and concordance among guidelines was poor to fair. All categories of WASH interventions were featured in the guidelines. The majority of recommendations targeted community-level transmission (45%), 35% targeted within-household transmission and 20% both. CONCLUSIONS: Recent evidence suggests that interventions for effective cholera control and response to epidemics should focus on case-centred approaches and within-household transmission. Guidelines did consistently propose interventions targeting transmission within households. However, the majority of recommendations listed in guidelines targeted community-level transmission and tended to be more focused on preventing contamination of the environment by cases or recurrent outbreaks, and the level of service required to interrupt community-level transmission was often not specified. The guidelines in current use were varied and interpretation may be difficult when conflicting recommendations are provided. Future editions of guidelines should reflect on the inclusion of evidence-based approaches, cholera transmission models and resource-efficient strategies.
  • The field is ever further: In search of the elusive space of fieldwork

    Stellmach, D (SAGE Publications, 2020-01-07)
    This short reflection considers how humanitarian workers conceptualize and practice “the field” as a site of action. Through the use of narrative ethnography, and drawing on comparisons with the practice of academic anthropology, it attempts to draw out disciplinary assumptions that govern how and where humanitarian action is undertaken. It demonstrates how the field is a central imaginary that underpins the principles and performance of both anthropology and humanitarian action. It highlights how the conceptualization of “the field” is itself a methodological tool in the practice of humanitarian intervention.
  • HIV viral load algorithm

    Shroufi, A; van Cutsem, G; Phillips, A; Maman, D; Murphy, R; Duncan, K; Cambiano, V; Bansi-Matharu, L (Ovid Technologies (Wolters Kluwer Health), 2020-01)
    Letter to the Editor | No Abstract
  • New opportunities in tuberculosis prevention: implications for people living with HIV.

    Gonzalez Fernandez, L; Casas, EC; Singh, S; Churchyard, GJ; Brigden, G; Gotuzzo, E; Vandevelde, W; Sahu, S; Ahmedov, S; Kamarulzaman, A; et al. (Wiley Open Access, 2020-01-01)
    INTRODUCTION: Tuberculosis (TB) is a leading cause of mortality among people living with HIV (PLHIV). An invigorated global END TB Strategy seeks to increase efforts in scaling up TB preventive therapy (TPT) as a central intervention for HIV programmes in an effort to contribute to a 90% reduction in TB incidence and 95% reduction in mortality by 2035. TPT in PLHIV should be part of a comprehensive approach to reduce TB transmission, illness and death that also includes TB active case-finding and prompt, effective and timely initiation of anti-TB therapy among PLHIV. However, the use and implementation of preventive strategies has remained deplorably inadequate and today TB prevention among PLHIV has become an urgent priority globally. DISCUSSION: We present a summary of the current and novel TPT regimens, including current evidence of use with antiretroviral regimens (ART). We review challenges and opportunities to scale-up TB prevention within HIV programmes, including the use of differentiated care approaches and demand creation for effective TB/HIV services delivery. TB preventive vaccines and diagnostics, including optimal algorithms, while important topics, are outside of the focus of this commentary. CONCLUSIONS: A number of new tools and strategies to make TPT a standard of care in HIV programmes have become available. The new TPT regimens are safe and effective and can be used with current ART, with attention being paid to potential drug-drug interactions between rifamycins and some classes of antiretrovirals. More research and development is needed to optimize TPT for small children, pregnant women and drug-resistant TB (DR-TB). Effective programmatic scale-up can be supported through context-adapted demand creation strategies and the inclusion of TPT in client-centred services, such as differentiated service delivery (DSD) models. Robust collaboration between the HIV and TB programmes represents a unique opportunity to ensure that TB, a preventable and curable condition, is no longer the number one cause of death in PLHIV.

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